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Xeomin vs. Botox: Which Is Better?

Botox,

Industry News

2023-05-16

Last Updated On: 2024-01-26

Although the two products share the same active ingredient, there are notable differences between Botox and Xeomin.

Doctor Medica team

Anti-wrinkle injections of botulinum toxin type A are the world’s most common non-invasive aesthetic procedure. While “Botox” has become a catch-all term for cosmetic injections, ‌the FDA has approved multiple types of botulinum toxin type A injections for aesthetic purposes. This article will discuss and compare two products – Botox versus Xeomin.

What Is Xeomin?

Xeomin is an innovative drug that uses botulinum toxin type A in cosmetology to perfect one’s appearance. It reduces active facial expressions, relaxes facial muscles, and smooths unwanted wrinkles. MerzPharma, a German pharmaceutical company, produces this cosmetic product often used in cosmetic procedures. Due to the small molecular weight, Xeomin successfully reaches even the most minor facial muscles.

Composition and Properties

Xeomin, the Botox alternative, boasts sterile lyophilized botulinum neurotoxin type A as its primary active ingredient. 

Plus, unlike Botox, Xeomin does not contain any additional protein impurities acting as preservatives. Therefore, it minimizes the risk of allergies. Due to the absence of protein inclusions in Xeomin, the injections do not provoke transient side effects, such as hyperemia and swelling, so they can be considered a “lunchtime procedure.”

The second feature of Xeomin is its low molecular weight – 150 kDa. As a result, it allows regulating the activity of even the smallest and thinnest facial muscles (for example, Xeomin successfully corrects “rare” horizontal wrinkles of the bridge of the nose that appear because of strong squinting of the periorbital area when laughing).

Xeomin has a low degree of diffusion. As a result, it significantly reduces the migration of the solution into nearby tissues, ‌‌practically eradicating unsightly side effects, such as droopy or raised eyebrows. After the injections, the “live” facial expression is preserved to the maximum extent.

It takes less Xeomin to correct facial wrinkles than Botox, meaning the procedure cost is automatically reduced compared to its analogs. However, Xeomin also has a shorter duration of action – it works for up to 3–4 months. Patients can repeat injections up to 2 times a year.

The risk of developing tolerance to Xeomin is extremely low. The effect of injections with systematic use of the product is not reduced and does not change.

Indications For Xeomin Injections

In most cases, Xeomin is used to correct expression lines in the upper and lower thirds of the face and neck area. The product is almost never used for treating hyperhidrosis.

The product is injected into the following areas:

  • Forehead (to smooth out horizontal and vertical forehead/nose bridge wrinkles);
  • Eye area (for smoothing wrinkles in the outer corners of the eyes, nasolacrimal area, and on the cheeks);
  • Nasolabial triangle (to smooth out radial wrinkles around the mouth);
  • Neck and décolleté zone (to smooth out vertical wrinkles).

It takes 2 to 30 units to correct one area, depending on the size of the area and the severity of the initial problems.

Xeomin Effect

The effect of Xeomin is to smooth out superficial and deep facial wrinkles and temporarily neutralize overactive facial expressions. 

The primary effect of Xeomin injections is observed 2–3 days after the procedure and peaks 10–17 days later, depending on individual body characteristics.

What Is Botox?

Botox is a muscle relaxant based on botulinum neurotoxin type A, manufactured by Allergan. Botox is the most researched and safest botulinum toxin drug. It is certified in 83 countries, approved by the FDA, and widely used in medical practice since 1989. It is prevalent in cosmetology as an effective treatment remedy for expression line correction and hyperhidrosis.

Composition and Properties

The main active ingredient of Botox is botulinum neurotoxin type A, synthesized from the protein complex of the bacteria Clostridium botulinum. The excipients are human serum albumin and sodium chloride solution. The principle of action involves a temporary blocking of the susceptibility of muscle fibers to nerve impulses. This results in an isolated relaxation (reduction of tone) of the facial musculature.

Botox applications for cosmetic purposes are permitted from age 18 to 65. Injections are usually sought after the age of 30, when the skin’s contractility decreases, and expression lines deepen. For patients with active facial expressions, Botox can be injected for preventive purposes from the age of 23-25.

Indications for Botox Injections

There are two main indications for Botox injections:

  • Mimic wrinkles;
  • Hyperhidrosis.

The product does not affect linear and structural furrows and folds and has no internal rejuvenating effect on the epidermis and dermis.

The product is injected into the following areas:

  • Frontalis muscle (for smoothing forehead wrinkles);
  • The brow muscles (for smoothing nose bridge wrinkles);
  • Periorbital muscles (for smoothing “crow’s feet,” or wrinkles in the outer corners of the eyes);
  • Perioral muscles and circular muscles around the mouth are specifically targeted to give a subtle lift to the drooping lip corners and smooth upper lip wrinkles.
  • Hyperhidrosis areas (areas of the body with increased sweating – armpits, palms, feet).

Wrinkle correction in one area requires 4 to 25 units of medication, depending on its location and problem severity. Hyperhidrosis treatment may require up to 300–400 units of the drug. Determining the degree of hyperhidrosis and the required dosage is usually done with a Minor’s test.

Botox Effect

Botox is a highly effective treatment for eliminating expression lines, resulting in a subtly rejuvenated appearance. Patients often praise Botox for restraining active facial expressions, thus preventing deep creases in the future.

Another effect of Botox is reducing sweating in problem body areas.

The primary effect occurs within 3–7 days, and the final effect within 1.5-2 weeks.

Botox vs Xeomin: Key Differences

Although the two products share the same active ingredient, there are notable differences between Botox and Xeomin.

Composition: Xeomin and Botox both contain the active ingredient botulinum toxin type A, which works by blocking nerve signals to muscles, causing them to relax. However, Xeomin is a “naked” or “pure” form of botulinum toxin, meaning it does not contain additives or complexing proteins. In contrast, Botox contains complexing proteins that help protect the active ingredient and make it more stable.

Onset and duration of action: Xeomin may take slightly longer to take effect than Botox, but the results may last longer. Typically, Xeomin takes around 3–4 days to start working, while Botox may begin to take effect within 24–48 hours. In addition, the effects of Xeomin may last anywhere from 3 to 6 months, while Botox typically lasts around 3 to 4 months.

Dosage: The dosing for Botox and Xeomin can vary depending on the treatment area and the patient’s needs. Generally, Xeomin requires higher doses than Botox, potentially resulting in a lower cost for the same treatment area.

Allergies: Botox injections may trigger allergic reactions in certain individuals due to the presence of complexing proteins, resulting in side effects such as inflammation, itching, or redness at the site of injection. Xeomin does not contain any complexing proteins, so it may be a better choice for patients concerned about potential allergies.

Benefits of Xeomin

Benefits of Xeomin over Botox include:

  1. Pure form of botulinum toxin with no complexing proteins, reducing the risk of developing antibodies that can make the treatment less effective over time.
  2. Lower risk of allergic reactions, as Xeomin does not contain any complexing proteins.
  3. Long-lasting results, up to 6 months in some patients.
  4. Comparable efficacy in treating wrinkles and other cosmetic concerns.
  5. Cost-effective option, as it is typically administered in higher doses than Botox, resulting in a lower overall cost for the same treatment area.

Benefits of Botox

Benefits of Botox over Xeomin include:

  1. Faster onset of action, with effects starting within 24–48 hours.
  2. Established safety and efficacy, with over 20 years of cosmetic use and FDA approval for multiple cosmetic concerns.
  3. Lower risk of spreading to other areas of the face due to the presence of complexing proteins.
  4. Established dosing guidelines to ensure consistent and predictable results.
  5. FDA approval for treating chronic migraines, providing additional benefits for patients with this condition.

Conclusion

In conclusion, despite the differences between Xeomin and Botox, they both are effective non-invasive aesthetic procedures for reducing wrinkles and relaxing facial muscles. Botox is a well-researched and widely used drug, whereas Xeomin is an innovative product with unique features like low molecular weight, lower risk of allergies, and fewer side effects. 

Xeomin is an excellent option for correcting fine lines caused by facial expressions, both in the upper and lower areas of the face and neck. On the other hand, Botox can also work wonders for treating hyperhidrosis. The decision to use either Xeomin or Botox should be based on the patient’s needs and the healthcare provider’s recommendations.

FAQ

Is Xeomin as good as Botox?

Patients often ask: does Xeomin work as well as Botox? Yes, Xeomin is as effective as Botox in treating wrinkles and other cosmetic concerns. However, the choice between the two products should be made after consulting a qualified healthcare provider.

Is Xeomin cheaper than Botox?

The cost of Xeomin and Botox can vary depending on factors such as the location and the healthcare provider. Xeomin may be a more cost-effective alternative for certain patients. It is typically administered in higher doses than Botox, which lowers the overall cost for the same treatment area. 

Is Xeomin more natural than Botox?

Xeomin and Botox contain the same active ingredient, botulinum toxin, derived from a bacterium. However, Xeomin is considered a “naked” or “pure” form of botulinum toxin, as it contains no additives or complexing proteins. So is Xeomin better than Botox? While each product has its own advantages, patients who are cautious about using a product with fewer additives may find Xeomin more attractive. 

References

  1. American Academy of Facial Esthetics. “Xeomin: What is it and how Xeomin compares to Botox.” n.d., https://www.facialesthetics.org/blog/xeomin-what-is-it-and-how-xeomin-compares-to-botox/.
  2. International Association for Physicians in Aesthetic Medicine. “Xeomin vs Botox vs Dysport explained.” n.d., https://iapam.com/xeomin-vs-botox-vs-dysport-explained.html.
  3. Merz Pharmaceuticals, LLC. Xeomin. 2021, package insert.
  4. Allergan, Inc. Botox Cosmetic. 2021, package insert.

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